Inside Medicine. What Are You Seeing? [COVID-19 medical news]

Everyone is masked here inside. No exceptions. I haven’t seen anyone inside a public place without a mask in nine months!

3 Likes

I would guess the number of cases in the community would drive the mask wearing mandates. When the number of cases/ hospitalized/ICU drops so will the restrictions.
I was one who was going to wait and see on the vaccination, but I am so tired of this pandemic I will probably take one as soon as it is available to me.

1 Like

Right. I expect there will be some guidelines and then the states will decide. Can’t very well make the decision by county - too small of a geographical area. Just wondering if there will be some percentage of people vaccinated as a goal to dropping mask mandates. Of course people could still wear masks if they are concerned even after the mandates are dropped.

There are two thresholds that are likely important to consider in making such a decision:

A. When vaccines are generally available to everyone, and everyone who wants the vaccine has gotten it. Surveys indicate that about 50-60% want the vaccine, about 20% do not want it, and the rest are not sure.

B. When there is herd immunity, meaning that a large enough percentage of the population has been vaccinated, and the vaccine is known to sufficiently reduce asymptomatic transmission.

The difference is important for those who are medically unable to get any of the COVID-19 vaccines, who would be better protected in scenario B than scenario A. What is yet unknown is how many people will be medically unable to get any of the COVID-19 vaccines.

3 Likes

Pitkin County CO (Aspen) has a new rule starting tomorrow that anyone staying must have a covid neg test 72 hours of arriving or agree to quarantine for 14 days. Cancellations are way up. The W Hotel has lost $70k in reservations for next week.

Seems like the W hotel is missing out on the opportunity to partner with a physician office that has rapid tests and do those in their lobby for customers upon arrival.

3 Likes

I don’t know about Colorado’s rules, but in MA a rapid test will not get you out of quarantine. You must get a molecular test.

I’m jealous. In our county and one next to us the ICU beds are full. One would expect people to change their ways. Mask compliance is higher than before in some places, but it’s nowhere near 100%.

I was just watching the news interview a truck stop owner about an hour away from us. He said many truckers are frustrated with masks and tell him he’s stupid. I loved his response. He said, “Maybe we are, but the doctors and scientists all around us - they’re not stupid.”

4 Likes

Well, still tons of Covid spread here so don’t be too jealous. Mask compliance seems 100 percent where it’s mandated but lots of people still socialize without masks privately. Even though everyone in our house only has a small number of people we see without masks, we’ve had a couple of scares that resulted in quarantines for me and for our D - luckily so far we both ended up negative when testing five days after being near positive case and we each finished ten day quarantines just to be safe. I can’t wait to get a vaccine even though I’ll likely be in the last group!

5 Likes

Of course, a typical test is very backward looking, since it can tell you if an exposure or higher risk situation 5-8 days ago* resulted in a detectable infection. More recent exposures or high risk situations that resulted in infection may not have produced sufficient viral load to be detected. Also, a positive result means that you had a detectable and probably contagious viral load 2-3 days ago without necessarily knowing it, so you could have spread it to others unless you were quarantining or otherwise avoiding going near others.

*Based on testing on day 3-5 after the possible infection to see sufficient viral load after incubation, and 2-3 day wait time for test results.

1 Like

I was not arguing the science, simply stating the rules. In MA, a negative molecular test gets you out of quarantine after travel. I’m not saying it’s right or wrong, but that’s the rules that the state has made.

The rule is not a Colorado rule but a Pitkin county rule. I’m not sure an instant test works to satisfy the requirement.

People just don’t want to deal with it and can change their reservations to Vail or Telluride.

Even people from Colorado need the negative test. I think there are 4 counties that are exempt, but those are the counties closest to Aspen so it is less likely those county residents would stay in Aspen.

Just an example of trying to twist the exceptions. Don’t open if it is that much of a concern. Most of Colorado is in RED level, but Pitkin is in Orange, so that mean they can have inside dining.

Eventually, someone will write a book cataloguing every single utterance Fauci’s made in regards to covid. The good, bad, open ended and ambiguous.

I look forward to it so eagerly that I’ll share the spoiler in advance: significant percentage of them simply weren’t true. The “we don’t really know”, etc., is the tell.

As to mask compliance: what would be really interesting is a bang-up study that correlates infection rates in the US to mask compliance. Maybe they correlate very well but…

Of course, many people have difficulty with unknowns, possibilities, or ambiguities.

Someone who knows about X: “X is a possibility, but we do not know now if X is true.”

Both Person 1 and Person 2 hear the above statement and later tell others…

Person 1: “I heard that X is true.”
Person 2: “I heard that X is not true.”

5 Likes

Yes, ucbalumnus, that is my understanding. What I’ve heard recently from the top experts is that there are major clues that these vaccines are indeed sterilizing vaccines, but there is not yet definitive proof. So until there is definitive proof, masks all around! But there is very good reason to be hopeful that people who are vaccinated will not only not get sick themselves, but will not be able to spread the virus. Keep fingers crossed, but it’s looking good.

4 Likes

Not sure where to ask this so thought I’d try here. I have been accepted into the novavax vaccine trial. Its a protein-based vaccine (unlike the mRNA vaccines) but does not have live Covid virus. I am expecting an email tomorrow with more details. Does anyone know anything about this vaccine trial?

Here’s what the nytimes has:

Vaccine name: NVX-CoV2373
Efficacy: Unknown
Dose: 2 doses, 3 weeks apart
Type: Muscle injection
Storage: Stable in refrigerator

Maryland-based Novavax makes vaccines by sticking proteins onto microscopic particles. They’ve taken on a number of different diseases this way; their flu vaccine finished Phase 3 clinical trials in March. The company launched trials for a Covid-19 vaccine in May, and the Coalition for Epidemic Preparedness Innovations has invested $384 million in the vaccine. In July the U.S. government awarded Novavax another $1.6 billion to support the vaccine’s clinical trials and manufacturing.

After getting promising results from preliminary studies in monkeys and humans, Novavax launched a Phase 2 trial in South Africa in August. The blinded, placebo-controlled trial on 2,900 people will measure not just the safety of the vaccine but its efficacy. The following month, Novavax launched a Phase 3 trial enrolling up to 15,000 volunteers in the United Kingdom. It is expected to deliver results in early 2021. A larger Phase 3 trial in the United States is expected to launch by the end of December.

In September Novavax reached an agreement with the Serum Institute of India, a major vaccine manufacturer, that they said would enable them to produce as many as 2 billion doses a year. If the trials succeed, Novavax expects to deliver 100 million doses for use in the United States by the first quarter of 2021. On Nov. 4 they announced another agreement to deliver 40 million doses to Australia.

You can see the protocol at clinicaltrials.gov

Don’t you work in healthcare though, and would be in line to receive the Pfizer or Moderna vaccine relatively soon?

Thanks for the info! I do still have my professional license, but I am no longer doing clinical work/seeing patients so don’t know if I would qualify as “healthcare”.But I am over 65. So trying to weigh the pros and cons.

2 Likes

My question is if you are in the placebo arm, how long do you agree not to get another vaccine?

1 Like

Dont have all the details, but presumably if/when they get an EUA, the volunteers will be notified if they had the placebo and will then be able to get the vaccine.